Assessment of tumor size as a useful marker for the surgical staging of endometrial cancer

Berretta, Roberto; Patrelli, Tito Silvio; Migliavacca, Costanza; Rolla, Martino; Franchi, Laura; Monica, Michela; Modena, Alberto Bacchi; Gizzo, Salvatore

doi:10.3892/or.2014.3108

Cited by 35 publications

(30 citation statements)

References 30 publications

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“…EEC is typically associated with a lower aggressiveness and an improved long-term disease-free survival following adequate treatment compared with that of other ECs (24). Histology, depth of MI, tumor grade, presence of LVSI, positive peritoneal cytology, tumor size and LNS have been universally recognized as prognostic factors for determining long-term clinical course of the disease (25,26). Although certain studies have evaluated the association between AM and the clinical course of EEC, the mechanism by which AM interferes with tumoral progression remains unresolved (9,12,27,28).…”

Section: Discussionmentioning

confidence: 99%

Coexistence of adenomyosis and endometrioid endometrial cancer: Role in surgical guidance and prognosis estimation

et al. 2015

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Abstract.The aim of the current study was to diagnose the concomitant presence of adenomyosis (AM) in endometrioid endometrial cancer (EEC) in order to evaluate its value as an oncological prognostic marker. A retrospective analysis of 289 patients diagnosed with EEC who underwent total hysterectomy, bilateral salpingo-oophorectomy and pelvic-lymphadenectomy was conducted. The total cohort included 37 patients in Group A (those with concomitant AM and EEC) and 252 patients in Group B (those affected only by EEC). The following factors were evaluated: Presence or absence of AM, tumor grade, depth of myometrial invasion, tumor size, lymphovascular space involvement, lymph node status, peritoneal cytology, concomitant detection of endometrial atypical-hyperplasia or polypoid endometrial features and tumor stage according to the International Federation of Gynecology and Obstetrics (FIGO) classification. Uterine examination of different sections of uterine cervix, corpus, myomas and cervical or endometrial polyps was performed. The diagnosis of AM was confirmed when the distance between the lower border of the endometrium and the foci of the endometrial glands and stroma was >2.5 mm. Parametric and nonparametric statistical tests were performed when possible; continuous variables were analyzed using a Student's t-test, and categorical variables were analyzed by the χ 2 test or Fisher's exact test. The association between FIGO stage and group was determined to be significant: 83.8% of Group A patients were categorized as FIGO stage I, vs. 68.7% of Group B patients. In addition, Group A was associated with lower grades in FIGO stage, myometrial invasion, lymphovascular space involvement, lymph node involvement and tumor size. The findings suggest that the intraoperative evaluation of the presence of AM in patients with EEC may aid surgeons in estimating oncological risk and in selecting the most appropriate surgical treatment.

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Section: Discussionmentioning

confidence: 99%

Coexistence of adenomyosis and endometrioid endometrial cancer: Role in surgical guidance and prognosis estimation

et al. 2015

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“…The median length of post-operative hospitalization was 3 days (2-5) in Group-0, 6 days (3-10) in Group-1 and 4 days (3)(4)(5)(6)(7)(8) in Group-2. The length of hospitalization for the three groups was significantly different between Group-0 vs Group-1 (p<0.001), between Group-0 vs Group-2 (p=0.006) and between Group-2 vs Group-1 (p<0.001).…”

Section: Resultsmentioning

confidence: 99%

“…Pelvic lymph nodes removal was performed according to grading (grade 3 or grade 2 with estimated myometrium invasion more than 50 %) and preoperative imaging features (bulky lymph nodes, myometrium invasion more than 50 %, estimated tumor size larger than 3 cm) [8].…”

Section: Methodsmentioning

confidence: 99%

Quality of Life in Patients Affected by Endometrial Cancer: Comparison Among Laparotomy, Laparoscopy and Vaginal Approach

Berretta

Gizzo

Noventa

et al. 2015

Pathol. Oncol. Res.

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The aim of this study is to verify if the surgical approach (laparoscopy/laparotomy/vaginal) in stage-I endometrial cancer treatment, may have effects on intra- and post-operative outcomes and on the patient's quality of life. The study group consisted of patients with histological diagnosis of type-I endometrial adenocarcinoma, stage-I. They were divided into three groups according to surgical approach chosen (laparotomic/laparoscopic/vaginal). Every patient answered a telephone health survey (SF-36) at 30 and 180 days post-surgery. Surgical-operating times, hospitalization length and short/long-term complications after surgery were also compared. The SF-36 survey revealed a better performance status in patients who underwent laparoscopy as compared to those who received laparotomy or vaginal surgery. We found significantly better results considering General Health, Physical Functioning, Role-Physical and Bodily Pain in the laparoscopy group after 30 and 180 days. Patients who underwent laparoscopy had significantly shorter hospitalization and less post-operative complications even if laparoscopy required significantly longer surgical-operating times compared to vaginal surgery. Our data confirm the superiority of the laparoscopic approach respect to the laparotomic and vaginal ones both in term of hospitalization length and post-operative complications.

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“…If RAL anticancer activity in endometrial cells can be confirmed, a further topic of study could be the evaluation of its preoperative use in reducing endometrial tumor size and improving the overall estimated oncological risk (Berretta et al, 2014;Gizzo et al, 2014c).…”

Section: Discussionmentioning

confidence: 98%

Could in-vitro studies on Ishikawa cell lines explain the endometrial safety of raloxifene? Systematic literature review and starting points for future oncological research

Gizzo

Noventa²,

Gangi³

et al. 2015

European Journal of Cancer Prevention

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To evaluate all the in-vitro raloxifene (RAL) mechanisms of action on normal, Ishikawa, and different endometrium-derived cell lines to explain the in-vivo RAL endometrial effects, a systematic literature search was performed in the electronic databases MEDLINE, EMBASE ScienceDirect, and the Cochrane Library for the time period between 2002 and 2012. Outcomes were considered in relation to in-vitro stimulatory, inhibitory, or neutral actions of RAL in Ishikawa cell lines compared with different endometrial-derived cell lines (both cancerous and normal endometrium). We also considered all the RAL molecular mechanisms responsible for the in-vitro effects observed. More than 150 articles were available in the scientific database literature, but only 21 fulfilled our selection criteria. Although in-vitro studies appear to yield conflicting results, most evidence has shown that RAL seems to induce endometrial cell mitochondria-mediated apoptosis, and to inhibit estrogen-related cell proliferation and endometrial carcinogenesis by inducing antiangiogenic factors, and reducing cytoskeletal reorganization. If the endometrial safety profile of RAL is confirmed, in the near future, selective estrogen receptor modulators could represent an efficient alternative adjuvant treatment to tamoxifen (TAM) in women with breast cancer considered to be at an increased risk of endometrial disease. The confirmation of the endometrial safety profile could enable the proposal of RAL by clinicians as the most appropriate treatment for BRCA1-2 patients after prophylactic salpingo-oophorectomy.

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Assessment of tumor size as a useful marker for the surgical staging of endometrial cancer

Cited by 35 publications

References 30 publications

Coexistence of adenomyosis and endometrioid endometrial cancer: Role in surgical guidance and prognosis estimation

Coexistence of adenomyosis and endometrioid endometrial cancer: Role in surgical guidance and prognosis estimation

Quality of Life in Patients Affected by Endometrial Cancer: Comparison Among Laparotomy, Laparoscopy and Vaginal Approach

Could in-vitro studies on Ishikawa cell lines explain the endometrial safety of raloxifene? Systematic literature review and starting points for future oncological research

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